Stress-Related Bruxism in PTSD Patients: A Hidden Struggle
If you’re dealing with the daily pain of clenching, grinding, or bracing your teeth, you know how exhausting it can be. Whether you suffer from headaches, jaw pain, or tension in your neck and shoulders, these symptoms often feel relentless. For people living with PTSD, bruxism—the habit of grinding or clenching our teeth—can be even more severe, as trauma and stress take a physical toll on our bodies.
Whether you’re a veteran who has experienced the stress of combat or a civilian who’s endured other forms of trauma, the connection between PTSD and bruxism is undeniable. Understanding why this happens and how to treat it is the first step toward finding relief and regaining control over your life. In this article, we’ll explore how trauma influences bruxism, the challenges of treating PTSD-related jaw pain, and the effective treatments that can help break the cycle of clenching, grinding, and pain.
The Connection Between PTSD and Bruxism
For those who suffer from clenching, grinding, and the constant pain that comes with it, bruxism is more than a bad habit. It’s a condition often rooted in stress, anxiety, and trauma. If you’ve experienced PTSD, whether from combat, abuse, or another traumatic event, you’re no stranger to how trauma can take over your life — and your body.
How Stress and Trauma Affect the Body
When we face trauma, especially in the form of PTSD, our body doesn’t just forget. It holds onto that stress, locking it into our muscles and joints. For many, this stress manifests as constant jaw tension, leading to clenching, grinding and thrusting activity.
Our body’s fight-or-flight response, designed to protect us from immediate threats, can stay “on,” even when there’s no immediate danger. This leaves our muscles, especially in the jaw, neck, and face, tight and overworked.
Nighttime is often the worst. PTSD can disrupt sleep patterns, leading to nightmares and restless tossing and turning. During this time, you may grind your teeth without even knowing it. The result? You wake up with a sore jaw, tension headaches, and teeth that ache as if they’ve been at war themselves.
Bruxism as a Coping Mechanism
For many people with PTSD, bruxism acts as a subconscious way to release tension. The trauma may be mental, but your body expresses it physically. Clenching and grinding your teeth might be your body’s way of “doing something” with all that stress it can’t process. Unfortunately, this coping mechanism doesn’t come without consequences. Prolonged grinding can damage your teeth, cause chronic headaches, and lead to severe facial pain that makes everyday life a struggle.
But it’s not just about the short-term pain. Over time, bruxism can become a learned habit, something your body does automatically in response to stress. Before you know it, you’re clenching even when you’re not actively feeling anxious. The pain becomes a constant companion, making it hard to focus, sleep, or relax.
The Role of Chronic Stress in the Development of Bruxism
Chronic stress, especially the kind linked to PTSD, wears the body down. When you’re in a constant state of high alert, your muscles never fully relax. This leads to what feels like a never-ending cycle: stress leads to clenching, clenching leads to pain, and the pain itself creates even more stress.
If left untreated, this can cause serious damage not only to your teeth but also to the temporomandibular joint (TMJ), the muscles of mastication, and the surrounding areas.
The long-term consequences of chronic bruxism can be devastating. From worn-down teeth to constant facial pain, the physical effects add to the emotional burden of PTSD. But for many, the hardest part is the feeling of being trapped — stuck in a cycle of clenching and pain that feels impossible to break.
PTSD as a Risk Factor for Bruxism in Both Veterans and Non-Veterans
Whether you’re a veteran who has seen the horrors of war or someone who has endured other forms of trauma, the risk of developing bruxism is significantly higher if you have PTSD. Studies have shown that PTSD patients are more likely to experience bruxism than the general population, regardless of the type of trauma. However, the severity and specific patterns of bruxism may differ between individuals.
For veterans, combat-related trauma often results in more intense muscle tension during sleep, leading to severe grinding and jaw pain. In civilians, particularly those who have experienced sexual assault or other types of abuse, the emotional triggers might be different, but the end result is the same: aching jaws, headaches, and the daily struggle of dealing with the pain caused by clenching and grinding.
If you find yourself bracing your teeth, either during the day or night, and you’ve experienced trauma, it’s important to recognize that your body is responding to that trauma. The tension and pain are real, but they don’t have to define your life.
Veterans and War-Related PTSD: The Physical Toll of Combat Stress
High Prevalence of Bruxism in Veterans
Veterans who have experienced the intense stress of combat often face an overwhelming physical and emotional toll. Bruxism, specifically clenching and grinding, is extremely common among veterans with PTSD. In fact, research shows that veterans suffer from bruxism at much higher rates than the general population.
This is not surprising, considering the constant high-alert state many veterans endure during and after their service. The body becomes conditioned to hold onto stress, even during sleep.
Combat trauma creates a unique kind of tension in the body. The hypervigilance experienced during wartime often carries over into sleep patterns, which is why sleep bruxism is particularly common in veterans.
The nightmares, flashbacks, and anxiety that accompany PTSD can trigger involuntary grinding and clenching of the teeth, leading to morning headaches, jaw stiffness, and facial pain that can last all day.
Beyond the mental and emotional strain, the physical act of bruxism takes a heavy toll on veterans. The muscles of the jaw, particularly the masseter and temporalis muscles, can become overworked from repeated clenching.
This can lead to temporomandibular joint (TMJ) disorders, which cause jaw pain, limited jaw movement, and clicking or popping sounds in the jaw. For many veterans, this pain becomes a constant reminder of their trauma, further complicating their recovery.
Pain and Discomfort from War-Related Stress
Living with bruxism means waking up with more than just sore jaws. The chronic pain caused by clenching and grinding affects the entire head and neck region, often leading to tension-type headaches that make it difficult to concentrate or relax.
Veterans often report feeling as though their teeth are “locked” in place, with tightness that radiates into their temples, neck, and shoulders. This can make the already challenging symptoms of PTSD, much worse, creating a vicious cycle of stress, pain, and frustration.
If left untreated, bruxism can cause permanent damage to the teeth, such as wear, fractures, and even tooth loss.
Unfortunately, many veterans may not have easy access to dental care or mental health support, meaning the pain goes untreated for years. For those who do seek help, it is often difficult to find providers who understand the unique connection between combat-related PTSD and physical conditions like bruxism. This gap in care can leave many veterans feeling isolated and unsure where to turn.
Combat-related PTSD doesn’t just affect the mind; it leaves its mark on the body, too. Chronic bruxism and the resulting TMJ pain are physical manifestations of that stress. The struggle for veterans goes beyond mental health—managing the physical pain of clenching and grinding can become just as important to the healing process.
Veterans may also face unique challenges when it comes to treatment. Finding appropriate dental care that addresses the long-term effects of bruxism, such as enamel erosion and cracked teeth, can be difficult. At the same time, mental health care for PTSD can focus solely on emotional trauma, without taking into account the physical pain that often accompanies it.
For many veterans, the constant jaw and facial pain becomes intertwined with their emotional pain, making it difficult to separate the two. That’s why it’s critical to take a holistic approach to treatment—one that addresses not just the psychological trauma, but also the physical symptoms, like bruxism, that arise from it.
Understanding that clenching and grinding are direct responses to the trauma they’ve faced is the first step toward healing. Proper treatment can make a world of difference, not just for managing PTSD, but also for breaking free from the cycle of chronic pain that so many veterans endure.
Non-Veteran Populations with PTSD: A Similar, Silent Battle
PTSD from Non-Combat Trauma
For people who aren’t veterans but have experienced other types of trauma, the impact of PTSD on physical health is just as profound. Whether the trauma stems from sexual assault, childhood abuse, a car accident, or any other life-altering event, the body responds to stress in a similar way—through tension and, for many, clenching or grinding their teeth.
Unfortunately, non-combat PTSD is often overlooked when it comes to the connection between stress and bruxism, but the numbers tell a different story.
Non-veteran populations with PTSD also experience bruxism at alarmingly high rates. Trauma survivors often carry the physical weight of their emotional pain in their jaws, necks, and heads. The muscles of mastication (the masseter, temporalis, and pterygoids) become overactive, leading to constant clenching or grinding, whether during the day (awake bruxism) or at night (sleep bruxism). This can make an already challenging recovery process even more difficult by adding physical pain to emotional turmoil.
For survivors of sexual assault or domestic violence, in particular, the body’s response to trauma often manifests as muscle tension. It’s a way of bracing against danger, even long after the threat has passed. The jaw becomes central to this tension, locking in pain that radiates through the face and head. This leads to chronic headaches, TMJ disorders, and worn-down teeth—conditions that many non-veterans don’t even realize are linked to their trauma.
The unfortunate reality is that many people with non-combat PTSD may not seek treatment for their bruxism. Economic barriers, a lack of access to specialized care, and even the stigma surrounding PTSD can prevent survivors from getting the help they need. Dental and mental health care are often seen as separate, when in reality, they are deeply interconnected for anyone suffering from stress-related bruxism.
Clenching and Grinding in Everyday Life
If you find yourself clenching your teeth throughout the day—whether you’re aware of it or not—it’s likely your body’s way of coping with stress. Many of us who deal with bruxism don’t even realize we’re clenching until we feel the ache in our jaws, the tightness in our temples, or the tension in our necks. This is known as awake bruxism, and it’s a common response to PTSD triggers that arise during daily activities.
For trauma survivors, everyday stressors can trigger a response similar to those experienced during the traumatic event itself. This could be anything from a loud noise to a confrontation at work. Without realizing it, your body braces for impact—your jaw clenches, your teeth grind, and the cycle of pain begins. What’s frustrating is that many people don’t associate their daytime clenching with their PTSD, but the connection is there, and it’s powerful.
The effects of clenching and grinding during the day extend beyond just the pain. Over time, awake bruxism can lead to permanent damage to the teeth, like chipped enamel, flattened chewing surfaces, and even cracked or fractured teeth. Worse, the more you clench, the tighter your jaw muscles become, which can exacerbate TMJ disorders and contribute to severe headaches.
Recognizing that these everyday responses are linked to PTSD can be a major turning point for anyone struggling with bruxism. Understanding that your body is reacting to stress, even when you’re not consciously aware of it, opens the door to addressing both the physical and emotional aspects of your pain.
The Role of Trauma Triggers in Exacerbating Daytime Clenching
For those of us with PTSD, triggers can come out of nowhere, and our bodies react before our minds have a chance to catch up. It’s not uncommon to find yourself clenching your teeth without realizing why, only to later recognize that something in your environment triggered a memory or emotional response tied to your trauma. Whether it’s a particular smell, sound, or situation, these triggers can activate the same fight-or-flight response that leads to clenching and grinding.
If you’ve experienced trauma, it’s important to identify these triggers as part of your healing process. By understanding what sets off your body’s tension response, you can begin to work toward reducing the physical pain associated with bruxism. This might involve cognitive behavioral therapy (CBT), biofeedback therapy, mindfulness practices, or simply being more aware of when you’re clenching so you can consciously relax your jaw.
What is Cognitive Behavioral Therapy (CBT)?
Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that helps individuals identify and change negative patterns of thinking and behavior. The central idea of CBT is that our thoughts, feelings, and behaviors are interconnected, and that by changing how we think about a situation, we can change how we feel and behave in response to it.
In the context of bruxism, especially when linked to stress or PTSD, CBT can be highly effective. It helps patients recognize the triggers that lead to clenching or grinding and provides practical strategies to manage stress and reduce jaw tension. Through relaxation techniques, stress management, and mindfulness, CBT teaches patients to break the cycle of stress-related bruxism by altering their thought processes and physical responses to stressful situations.
What is Biofeedback Therapy for Bruxism?
Biofeedback is a powerful tool that can help people with bruxism gain control over the unconscious habit of clenching and grinding their teeth. It works by teaching you to become more aware of your body’s physical responses to stress, such as muscle tension in the jaw, and provides real-time feedback to help you learn how to relax those muscles.
By monitoring your jaw movements or muscle activity, biofeedback therapy can guide you toward recognizing when you are clenching or grinding, allowing you to consciously reduce the tension. This non-invasive therapy is particularly effective for people whose bruxism is stress-induced or linked to conditions like PTSD, offering a way to manage the condition without medication or invasive procedures.
Bruxism, whether awake or asleep, is a physical manifestation of the stress and trauma that PTSD patients—both veterans and non-veterans—carry with them every day. Learning to recognize and manage this tension is a critical step in breaking the cycle of pain.
The Overlapping Experience of Veterans and Non-Veterans
Shared Symptoms: Bruxism, TMD, and Headaches
Whether you’re a veteran or a civilian, if you’re suffering from PTSD, the physical pain of clenching and grinding likely feels all too familiar. For those of us battling bruxism, the symptoms can be debilitating.
The intense pressure on the muscles of mastication from constant clenching creates tension throughout the head, neck, and shoulders. This often leads to chronic tension-type headaches that don’t seem to go away with typical pain relief methods.
Jaw pain is another common complaint among those of us dealing with bruxism. The pain can range from mild discomfort to sharp, radiating sensations in the temporomandibular joint (TMJ), which can make chewing, talking, and even yawning feel unbearable.
Over time, this constant tension takes its toll, not only on the jaw muscles but on the teeth as well. Wear and tear from grinding can lead to chipped, flattened, or even cracked teeth, which only adds to the cycle of pain.
For both veterans and non-veterans, these physical symptoms often overlap and feed off one another. The headaches, the jaw pain, the worn-down teeth—they all seem to be connected in a never-ending loop of discomfort. And while the causes may differ—combat-related trauma for veterans, non-combat trauma for civilians—the effects are strikingly similar.
It’s the shared experience of living with a body that constantly responds to trauma by clenching, grinding, and bracing for impact.
The frustration many sufferers feel is compounded by the fact that these symptoms are often misunderstood or minimized by healthcare providers.
The pain isn’t just “in your head”—it’s real, and it’s affecting your quality of life. Understanding that this pain is part of a larger, stress-related condition is crucial for both patients and providers. Only then can we begin to address the root causes and develop effective treatments for both the physical and emotional aspects of bruxism.
Difficulty in Differentiating PTSD-Induced Bruxism from Other Stress-Related Disorders
One of the challenges is that the symptoms of PTSD-induced bruxism often overlap with other stress-related disorders, making it difficult to pinpoint the exact cause of the pain. For example, anxiety and depression can also lead to clenching and grinding, but the underlying mechanisms may differ. PTSD tends to cause more intense, trauma-driven episodes of bruxism, particularly during sleep, whereas generalized anxiety may lead to more daytime clenching.
For veterans, the hypervigilance that comes with combat-related PTSD may exacerbate nocturnal bruxism, as the brain remains on high alert even during sleep. In contrast, non-veteran populations with PTSD may experience a different pattern, such as more awake bruxism triggered by everyday stressors or trauma reminders. Regardless of the pattern, the pain is very real, and it’s important to differentiate the root cause so that treatment can be properly tailored.
Trauma-Informed Care for PTSD Patients with Bruxism
What’s often missing from the treatment of bruxism in PTSD patients—whether veterans or civilians—is a trauma-informed approach. Too often, healthcare providers focus on the physical symptoms without considering the psychological triggers that might be driving the clenching and grinding. But for those of us who have experienced trauma, addressing the emotional aspects is just as important as managing the physical pain.
A trauma-informed approach to care means recognizing that your bruxism isn’t just a dental issue—it’s a response to the trauma your body has endured.
For veterans, this might mean acknowledging the role that combat stress plays in maintaining tension in the jaw.
For non-veterans, it might involve exploring how past abuse or traumatic events are manifesting physically through bruxism.
One of the most important aspects of trauma-informed care is empathy. Your healthcare provider should not only be knowledgeable about the connection between trauma and physical symptoms but also compassionate in their approach. If you feel that your pain is being dismissed or treated as purely a physical problem, it’s time to find someone who understands the complexities of PTSD and how it impacts the entire body, including the jaw.
Tailoring Treatment to the Individual’s Trauma History
Treatment for PTSD-related bruxism should never be one-size-fits-all. Your trauma is unique, and so is the way your body responds to it. For veterans, the intensity and frequency of bruxism may be linked to specific combat experiences, and treatment might involve both physical therapy for the jaw and mental health support for processing those experiences.
Custom-made splints or nightguards can help protect the teeth and alleviate some of the pressure on the TMJ, but addressing the psychological aspect is key to long-term relief.
For non-veterans, treatment may need to focus on managing the day-to-day stressors that trigger clenching and grinding. Cognitive Behavioral Therapy (CBT) is often effective for both veterans and civilians, as it helps patients develop healthier ways to cope with stress. Physical therapies, like jaw exercises and myofascial release, can also be beneficial in reducing muscle tension and preventing the long-term damage caused by bruxism. Biofeedback is a fairly recent treatment modality that alerts the sufferer of their clenching activity so they have the power to take preventive action.
No matter your trauma history, your treatment plan should be personalized to meet your specific needs. Whether you’re dealing with the aftereffects of combat or a different kind of trauma, it’s important to take a holistic approach to care—one that addresses both the emotional and physical components of your pain.
By integrating trauma-informed care with personalized treatment options, you can start to break the cycle of clenching, grinding, and pain. Understanding the link between PTSD and bruxism is the first step toward reclaiming control over your body and your well-being.
Conclusion
Living with bruxism, whether you’re a veteran or a non-veteran with PTSD, can feel overwhelming. The constant clenching, grinding, and resulting pain may seem like an inescapable part of your life. But there is hope. By recognizing the connection between your trauma and the physical toll it takes on your body, you’ve already taken the first step toward healing.
Treatment may be challenging—finding the right balance of dental care, physical therapy, and mental health support can take time. However, with a trauma-informed approach and personalized treatment plan, it’s possible to break the cycle of pain. Tools like custom nightguards, physical exercises, biofeedback and therapies such as Cognitive Behavioral Therapy can help you manage both the physical and emotional aspects of bruxism.
The road to relief may not be easy, but by addressing the underlying causes and working with compassionate healthcare providers, you can begin to feel more in control of your symptoms. With the right support, you can look forward to a life where pain doesn’t define your days—and where healing is truly possible.
Frequently Asked Questions (FAQ)
Bruxism is the involuntary habit of grinding, clenching, or bracing your teeth, which can occur either while awake or asleep. For individuals with PTSD, the stress and trauma associated with the condition can lead to bruxism as a physical response to emotional distress. The body stores tension in the jaw, leading to pain, headaches, and sometimes damage to the teeth.
PTSD triggers the body’s fight-or-flight response, keeping it in a state of heightened tension. This can lead to unconscious clenching or grinding of the teeth, especially during sleep or moments of stress. Both veterans and non-veterans with PTSD are prone to bruxism because trauma-related anxiety and hypervigilance can create physical symptoms like jaw tension.
Common symptoms include jaw pain, tension-type headaches, sore or sensitive teeth, neck and shoulder pain, worn or chipped teeth, and clicking or popping sounds in the temporomandibular joint (TMJ). In severe cases, bruxism can lead to TMJ disorders (TMD) and chronic facial pain.
Treatment for PTSD-related bruxism often involves a combination of dental care, physical therapy, and mental health support. Dental interventions like custom mouthguards can protect the teeth, while physical therapy or jaw exercises can help relieve muscle tension. Addressing the underlying trauma through therapy, such as Cognitive Behavioral Therapy (CBT), is also essential for long-term relief.
Yes, stress reduction techniques like mindfulness, meditation, and relaxation exercises can be very effective in reducing jaw clenching and grinding. Biofeedback, progressive muscle relaxation, and deep breathing can help you become more aware of when you are tensing your jaw and give you tools to stop it.
Veterans, particularly those with combat-related PTSD, may experience higher rates of bruxism due to the intense and prolonged nature of the stress they endure. However, non-veteran trauma survivors, such as those who have experienced abuse or accidents, also have a high prevalence of bruxism linked to PTSD.
If left untreated, bruxism can cause serious long-term issues, including worn or fractured teeth, chronic jaw pain, and TMJ disorders. Over time, the muscles of the jaw may become fatigued and inflamed, leading to headaches, neck pain, and limited jaw movement.
Trauma-informed care recognizes the deep connection between PTSD and physical symptoms like bruxism. It ensures that treatment addresses both the emotional and physical impacts of trauma, allowing for a holistic approach to healing. This care often involves working with dental professionals, mental health specialists, and physical therapists to create a comprehensive treatment plan.
Yes, a custom-fitted mouthguard can help protect your teeth from grinding and reduce the pressure on your jaw muscles, easing pain. It’s particularly effective for sleep bruxism, allowing you to rest without causing damage to your teeth. However, it’s important to combine dental care with therapy and stress management for optimal results.
References
- Knibbe, W., Lobbezoo, F., Voorendonk, E. M., Visscher, C. M., & de Jongh, A. (2024). Prevalence of painful temporomandibular disorders, awake bruxism, and sleep bruxism among patients with severe post-traumatic stress disorder. Journal of Oral Rehabilitation, 51(5), 911-914. https://doi.org/10.1111/joor.13367
- Minervini, G., Franco, R., Marrapodi, M. M., Fiorillo, L., Cervino, G., & Cicciù, M. (2023). Post-traumatic stress, prevalence of temporomandibular disorders in war veterans: Systematic review with meta-analysis. Journal of Oral Rehabilitation, 50(2), 235-242. https://doi.org/10.1111/joor.13535
- Shankland, W. E.** (2001). Temporomandibular disorders: Standard treatment options. Journal of the American Dental Association, 132(8), 1172-1181. https://doi.org/10.14219/jada.archive.2001.0325
- Visscher, C. M., Lobbezoo, F., & de Jongh, A. (2010). Bruxism and temporomandibular disorders: A qualitative study of the experience of patients with PTSD. Journal of Orofacial Pain, 24(2), 153-160.
- American Academy of Orofacial Pain (2020). Guidelines for assessment, diagnosis, and management of bruxism and temporomandibular disorders. https://www.aaop.org/guidelines
- Casuccio, A., & Fricton, J. R. (2008). The role of trauma in the development of temporomandibular disorders and bruxism. Journal of Trauma and Stress, 21(5), 492-501. https://doi.org/10.1002/jts.20386
- Lobbezoo, F., & Naeije, M. (2001). Bruxism is mainly regulated centrally, not peripherally. Journal of Oral Rehabilitation, 28(12), 1085-1091. https://doi.org/10.1046/j.1365-2842.2001.00814.x
- de Leeuw, R., & Klasser, G. D. (2018). Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. American Academy of Orofacial Pain.
- Carlson, C. R., Reid, K. I., & Curran, S. L.(1996). Psychophysiological and neuropsychological mechanisms underlying bruxism and chronic orofacial pain. Journal of Orofacial Pain, 10(3), 215-229.
- Shivapuja, P. K., & McNamara, J. A.(2006). Stress-induced clenching: The underlying psychological factors behind bruxism. Journal of Dental Research, 85(2), 154-160.
